J Korean Soc Surg Hand.  2010 Jun;15(2):59-64.

Percutaneous A1 Pulley Release of Locked Trigger Thumb in Children

Affiliations
  • 1Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, Korea. kimjp@dankook.ac.kr

Abstract

PURPOSE
To report the clinical outcomes of percutaneous A1 pulley release for the surgical treatment of locked trigger thumb in children.
MATERIALS AND METHODS
Twenty-six trigger thumbs in 24 patients with a average of 14.2 months follow-up after percutaneous release were enrolled. There were 15 females and 9 males with an average age of 39 months. The mean time from first presentation to surgery was 16 months. Procedures were performed under local anesthesia. Postoperative examinations at immediate, 3 months and 1-year recorded pain, triggering and range of motion and presence of complications.
RESULTS
All thumbs had a satisfactory result without digital nerve injury. Eleven patients(46%) had a mean 14.3degrees extension loss of the interphalangeal joint and 12.0degrees hyperextension of the metacarpophalangeal joint of the thumb, compared to the contralateral thumb. At final follow-up, all but 1 patient were completely resolved. The duration of symptoms and age were higher in the group with thumb deformity (p<0.05).
CONCLUSION
Temporary thumb deformity is possible after surgical treatment of trigger thumb in children with a long duration of symptoms. Percutaneous release can be a safe and satisfactory treatment option in pediatric trigger thumb.

Keyword

Trigger thumb; Children; Percutaneous release
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